BACKGROUND: Rapid collection of vaccination histories of cases and contacts is important in the investigation and control of vaccine-preventable diseases (VPDs). With funding from CDC, Oregon’s Enhanced Pertussis Surveillance (EPS) team exerts strenuous effort to ascertain vaccination status of pertussis cases in the Portland metropolitan area. When vaccination status appears incomplete on query of Oregon’s statewide immunization registry “ALERT IIS”, public health nurses contact patients or parents and physicians. The existence of two methods of data ascertainment allowed evaluation of data completeness in ALERT IIS. Engineering of interoperability between ALERT IIS and Oregon’s “Orpheus” reportable disease database stimulated an evaluation of the utility of interoperability in case investigations. OBJECTIVES: To determine the completeness of vaccination data in ALERT IIS and to assess the utility of Orpheus-ALERT IIS interoperability.
METHODS:
With EPS data from January–September 2015 entered into Orpheus as the gold standard, we measured the sensitivity of ALERT IIS as a source of case and high-risk contact vaccination records.
To increase the timeliness of ALERT IIS data acquisition for VPD cases and contacts, in September 2015 a “Query ALERT” button was created within Orpheus. This creates an HL7 VXQ^V01 message that is passed to a Rhapsody Integration Engine, which then uses it to query ALERT IIS via web service. ALERT IIS immediately sends a response that Rhapsody parses and passes back to Orpheus, which uploads the data.
Timeliness of vaccination data acquisition was measured in Orpheus as the lag between the creation dates of cases and related vaccination records.
RESULTS:
Through September, 490 cases of pertussis were reported in Oregon during 2015.
One hundred eighty-two cases were reported in the Portland metropolitan area; ALERT IIS was the source of vaccination history for 94 (95%) of the cases 2 months - 19 years of age. Sixty cases had no data available in ALERT IIS and proved to be unvaccinated.
From January through September 2015, immunization records of 466 Oregon cases were ascertained a median of 28 hours after case creation. Similarly, immunization records of 64 high-risk contacts were ascertained a median of 17 hours after case creation. During September 2015, immunization data for 24 cases and 9 high-risk contacts have been populated within the hour of the case creation.
CONCLUSIONS:
We estimate that ALERT IIS is 95% complete for vaccination records relevant to reported pertussis in Oregon. Orpheus-ALERT IIS interoperability significantly speeded the ascertainment of vaccination data for reported cases and high-risk contacts.